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Tuesday, January 22, 2013 – Daily News 1D FEATURES Hubby unhappy about guests Less-invasive heart surgery promising times and know you speak for thousands of devoted caregivers. But we also know that many relatives who live away need to feel as if they are contributing and often react by making demands and trying to take over. Sometimes, all they need is a task to perform that will make them feel they are needed in a concrete way. We hope that helps. Dear Annie: Like ''Heartbroken Mom in Connecticut,'' I, too, left a controlling husband, and it created conflicts at family gatherings. Our solution was to have two birthday parties. My ex could attend one with whomever he wished, and I attended the other. The grandchildren loved the idea of having two birthday parties. Over time, some of the conflicts lessened, but they never completely stopped. Sometimes they just can't let go. — Don't Stress, Celebrate Twice After your heart is exposed, DEAR DOCTOR K: I have your heart will be cooled and aortic valve regurgitation and stopped while the surgery is need to have my aortic valve being performed. That's replaced. What will happen durbecause it's hard to perform ing this procedure? surgery on a beating heart. DEAR READER: When it's Since your heart has stopped, working properly, your aortic you need a machine — a heartvalve opens to allow oxygen-rich lung machine — to get oxygen blood to flow from your heart into Dr. K in your blood and pump it your aorta and out to the rest of by Anthony L. around the body. your body. The aorta is the body's Once your heart is motionlargest blood vessel. (I've put an Komaroff, M.D. less, the surgeon will cut illustration of how healthy heart valves work on my website, AskDoc- through its muscular wall. He or she will remove the malfunctioning heart valve, torK.com.) Heart valves keep blood flowing in insert the prosthetic valve and stitch it just one direction — the direction the into place. After closing the incision in your heart wants to pump blood. Particularly when you're sitting or standing up, grav- heart wall, the surgeon will warm your ity wants to pull blood back down into heart. Once your heart is pumping steadithe heart from the aorta. If that hap- ly without leaking blood, you will be dispened, the heart would have to work connected from the heart-lung machine. much harder: It would keep having to The surgeon will reattach the halves of pump the same blood out into the circu- your breastbone and your chest incision lation. A healthy aortic valve prevents will be closed. For some patients, the heart surgeon gravity from pulling blood back down can replace a heart valve through a into the heart. Aging and disease can damage the smaller incision. New technologies allow aortic valve. If it doesn't close tightly, artificial valves to be inserted into the blood can re-enter the heart, causing aor- heart without making even a small opentic regurgitation. It can cause fatigue, ing in the patient's chest. Heart specialists are still gaining shortness of breath, fainting and other experience with these less-invasive symptoms. If your symptoms are severe, or if the approaches. There is little doubt that, condition is weakening your heart, you because they involve cutting into fewer may need to have your aortic valve tissues, patients heal more quickly. replaced with a prosthetic valve. Pros- However, it's not yet clear if the longthetic valves are either synthetic mechan- term results of less-invasive types of ical valves or biological valves made of surgery are as good as with traditional surgery. human or animal tissue. The traditional surgery involves splitDr. Komaroff is a physician and ting the breast bone, exposing the heart and then replacing the valve. An intra- professor at Harvard Medical School. To venous (IV) line is inserted into your arm send questions, go to AskDoctorK.com, to deliver fluids and medications. You or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115. will be given a general anesthetic. control every situDear Annie: ation. Good careMy 20-somegivers are proacthing children tive and vigilant. attend school in You are loved, and other cities. On your opinion matoccasion, they ters. But unless have asked to you are a medical bring their curexpert in these rent boyfriend or girlfriend home Annie's areas, please listen rather than for a visit to resort to preconmeet the family. The friend then by Kathy Mitchell ceived ideas. When you do stays in a sepa- and Marcy Sugar visit, don't say, ''I rate room for a guess you get the day night or two. The problem is my off.'' There is never a husband. He gets day off, especially if the extremely upset about loved one is in the hospithese visits and accuses tal or rehab and preparame of encouraging tions need to be made for immoral behavior. He what happens after they says that allowing these are discharged. And friends to stay at our while you may think it's house gives tacit ''too early'' to discuss approval for them to assisted living or nursing spend the night away home care, some of from home. I say it is those places have waitnormal hospitality to ing lists. It's never too open our home to our early. You may want to kids' friends. Is he being have a light, enjoyable irrational, or am I miss- visit, but some things ing something? — Con- still need to be handled, even unpleasant things. flicted Mother Dear Conflicted: Life doesn't get put on There is absolutely noth- hold simply because ing wrong with a child you're in town. If you want to take spending the night away from home, and certainly over the full-time care, not a 20-something you are more than weladult. Your husband come. Otherwise, please apparently is convinced respect the primary carethat the kids are sneak- giver's role and responsiing around and getting bilities, and keep your into bed together when interference with the you are asleep. But that medical providers to a is ungenerous of him. minimum. You have no These friends are guests idea what it is like to in your home and should have a family plus elderly be treated as such. And parents to care for, with your husband might keep all the activities, medical in mind that should these appointments, medicafriends turn out to be his tions and therapies to future sons-in-law or coordinate and facilitate. daughters-in-law, react- You purposely choose to ing poorly to them now live states away. Please could set him up for don't fly in and out telling me what to do. future difficulties. Serving as a primary Dear Annie: May I vent a little about the caregiver is an honor and extended family of a a privilege. It carries caregiver? My relatives with it a tremendous live out of state and responsibility, as well as rarely visit. This is for accountability and selfsacrifice. I do it out of them: Please don't tell the love, and I want what is primary caregiver what best for them. — Walk a to do and how to do it. Mile in My Shoes Dear Walk: We have You don't have all the details, and you do not heard this plea many Mailbox Annie's Mailbox is written by Kathy Mitchell and Marcy Sugar, longtime editors of the Ann Landers column. Please email your questions to anniesmailboxcomcast. net, or write to: Annie's Mailbox, c/o Creators Syndicate, 737 3rd Street, Hermosa Beach, CA 90254. 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